OHSU exonerated in nurse complaints

A nursing shortage at OHSU consistently led to an atmosphere of chaos, which nearly caused medical errors on at least 13 occasions from last June through September, according to nine nurses working in the hospital’s surgical operating unit.

The nurses filed complaints with the state’s Health Care Licensure and Certification Section. Because of confidentiality provisions, that agency could not disclose their names.

Despite credible testimony, state officials took no action against OHSU aside from citing the hospital for minor infractions of the nurse staffing law. Nurses’ actual claims that staffing shortages caused medical errors could not be verified by patient records or daily staff logs, the state agency concluded in its final report.

Insurance finances vary widely in 2005

Oregon insurers were all over the map in 2005. While medical-loss ratios — the percentage of premium that insurers pump back into medical services — remained constant, executive compensation, net income and enrollment figures varied widely. Meanwhile, an analysis of the state’s largest domestic health insurers shows that, overall, net income rose 25 percent last year, while enrollment rose 14 percent.

Aside from Kaiser Permanente, whose medical-loss ratio stood at 95.3 percent, the other carriers fell into line, spending between 80 to 85 percent of their premiums on medical costs — comparable to a similar trend in 2004.

A list of salaries and financial information not available in the April newsletter have been uploaded to the What's New section of our Web site.

Transparency future becomes more clear

Something’s better than nothing. That’s the mantra the Insurance Division tried to pump out when stakeholders gathered to talk publicly about the next steps for hospital cost transparency in early April.

“Perfect could be the enemy of the good,” said Joel Ario, administrator of the Insurance Division. “It will take a lot of work to move a system that’s quite opaque right now. This isn’t the perfect solution, but it does advance the ball.”

His goal is to paint a clearer picture for consumers on hospital costs. Initially, this may be as simple as making raw data available for policymakers and purchasers, who could then break it down for consumers.

Anti-trust is anti-climactic

Despite a judge’s ruling that threw out an anti-trust lawsuit against Providence Health System, the imaging companies that brought the case forward are confident they’ll eventually get their day in court through an appeal or a new lawsuit.

“As long as Providence continues on its present path, it’s really just a matter of time,” said Dr. Gerald Warnock, medical director of EPIC Imaging.

District Court Judge Garr M. King dismissed the case brought by EPIC Imaging and Body Imaging Radiology, which were kicked off the Providence PPO panel in 2005.

County moves on EMRs

After just four months experience with electronic medical records, Multnomah County’s Health Department has seen striking improvements at its north Portland clinic. It’s the first in the county’s system of seven clinics and school-based health centers to convert to electronic medical records (EMRs). By the end of 2006, the entire system of 60,000 patient records should be online.

EMRs have cut appointment visits almost in half — to just over an hour. And most of that time was shaved from the waiting room. Picking up medications or getting lab tests has also become easier. And cash flow is faster with same day billing occurring for nearly every visit. Previously, billing went out on the same day just 50 percent of the time.

Archimedes gets lever

The same tactics that helped soar Gov. Howard Dean to the forefront of the 2004 Democratic primary are lifting the Archimedes Movement off the ground — complete with an Internet campaign, community meetings across the state and eventually the nation. There’s another very striking similarity: Dean's former campaign manager Joe Trippi.

Trippi accompanied Gov. John Kitzhaber to a rally in early April attended by more than 300 people. The proposal, which still lacks specifics, would redistribute public health dollars and employer premiums to guarantee universal access focusing on prevention. But beyond that, the crux lies in the peoples’ hands.

AHPs gain steam in D.C.

With a compromised version of association health plans proposed by Sen. Michael Enzi (R—Wyo.) ready to reach the Senate floor, the sought after legislation is showing its greatest chance of becoming reality, which has put the Insurance Division in a sticky situation.

Because of the potential of cherry picking, the division has always felt association health plans could result in fewer people receiving coverage. But with rumors flying that the Bush administration could throw its support behind the House version (which has failed in the Senate eight consecutive times), it’s found itself considering the lesser of two evils.

“There clearly are problems with Enzi’s bill,” said Joel Ario, administrator. “But then there’s this issue of Enzi versus association health plans.”

CHC put on defensive

They say once you leave home you can never go back. Tami Chartraw is finding that especially true.

The central Oregon native got her start in the health care field volunteering as a candy striper for St. Charles Medical Center. Now the former corporate compliance officer for Cascade Healthcare Community, the parent company of St. Charles Medical Centers in Bend and Redmond, is in the midst of a legal battle on behalf of the U.S. government, alleging Medicare fraud, Stark II violations, HIPPA compliance concerns and wrongful termination. In a separate suit, she claims she earned less and was treated unfairly because of her gender.

Waiting time trimmed

The waiting list for Oregon’s state hospitals has been cut in half for those needing long-term treatment, opening up sorely needed psychiatric beds across the state.

“We previously had people waiting in emergency room departments or bouncing all over the state,” said Mike Morris, policy manager for the Office of Mental Health and Addiction Services. The situation has improved thanks to efforts by local mental health organizations working with state officials.

In fiscal 2004, on average 35 people were on the waiting list at one time. They spent an average of 33 days waiting for a state hospital bed. Now roughly 18 people are waiting an average of 17 days. There are 193 beds available at the state’s three hospitals.

Arms race in Eugene

Oregon health care’s technological arms race is well documented. In Eugene and Springfield, however, keeping up with the Jones’ is taking on a new meaning.

In late April, Drs. Jeffrey Wensel and Marc Garant will open a stand-alone imaging center in Eugene. Although it will be the area’s first to host a 3T whole body scanner, the city has three other free-standing MRI clinics.

Ambulatory surgery center construction in the region is even more explosive. In 2006 alone, plans have been filed with the Facilities Planning and Safety Division of Oregon Health Services for two new centers, a collective construction bill that’s tabbed at almost $4 million (not including internal equipment).

Also in this issue...

• Nursing Board fallout
• PDX IPA goes electronic
  
• Parity talks still divided
  
• Baumeister keeps fighting
  
• Bulldozers hit Burns

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